Cor-pulmonale: a rare presentation in a case of middle lobe syndrome

Authors

  • Ankit Abhishek Department of Medicine, Nalanda Medical College Hospital Patna, Bihar, India
  • Ajay Kumar Sinha Department of Medicine, Nalanda Medical College Hospital Patna, Bihar, India
  • Vikram Aditya Department of Medicine, Nalanda Medical College Hospital Patna, Bihar, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231656

Keywords:

MLS, Cor pulmonale, Chest imaging, Case report

Abstract

Brock’s syndrome or middle lobe syndrome (MLS) is chronic or recurrent collapse of right middle lobe due to causes which may be obstructive or non obstructive. The pathogenesis is not completely understood. An expert committee of the world health organization defined cor pulmonale as hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs.” Cor pulmonale is a common heart disease and a leading cause of disability and death. We are reporting this association in a 65y old female who presented to the emergency with acute exacerbation of COPD with SpO2=64% room air. Chest X-ray and HRCT thorax showed features suggesting MLS and ECG shows features suggesting P pulmonale /right atrial enlargement. BNP too was elevated. Patient was resuscitated and put on mechanical ventilation after ABG showed respiratory acidosis. Appropriate treatment with bronchodilators and antibiotics was given.

References

Anon. Chronic cor pulmonale. Report of an expert committee. Circulation. 1963;27:594-15.

Graham EA, Burford TH, Mayer JH. Middle lobe syndrome. Postgrad Med. 1948;4:29-34.

Brock RC, Cann RJ, Dickinson JR. Tuberculous mediastinal lymphadenitis in childhood; secondary effects on the lungs. Guy’s Hospital Resp. 1937;87:295.

Kwon KY, Myers JL, Swensen SJ, Colby TV. Middle lobe syndrome: a clinicopathological study of 21 patients. Hum Pathol. 1995;26(3):302-7.

Einarsson JT, Einarsson JG, Isaksson H, Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a nationwide study on clinicopathological features and surgical treatment. Clin Respir J. 2009;3(2):77-81.

Bertelsen S, Struve-Christensen E, Aasted A, Sparup J. Isolated middle lobe atelectasis: aetiology, pathogenesis, and treatment of the so-called middle lobe syndrome. Thorax. 1980;35(6):449-52.

Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a review of clinicopathological features, diagnosis and treatment. Respiration. 2012;84:80-86.

Wagner RB, Johnston MR. Middle lobe syndrome. Ann Tho-Rac Surg. 1983;35:679-86.

Sedlaczek AM. Analysis of the clinical course of pulmonary tuberculosis in women over 70 years of age. Pneumonol Pol. 1990;58:210-14.

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Published

2023-05-29

How to Cite

Ankit Abhishek, Sinha, A. K., & Aditya, V. (2023). Cor-pulmonale: a rare presentation in a case of middle lobe syndrome. International Journal of Research in Medical Sciences, 11(6), 2287–2291. https://doi.org/10.18203/2320-6012.ijrms20231656

Issue

Section

Case Reports